Gerard J P, Coquard R, Fric D, Ayzac L, Romestaing P, Ardiet J M, Rocher F P, Baron M H, Trillet-Lenoir V
Service de Radiothérapie-Oncologie, Centre Hospitalier Lyon Sud, Pierre Benite, France.
Eur J Surg Oncol. 1994 Dec;20(6):644-7.
The aim of this study was the analysis of 414 patients treated by endocavitary irradiation for small T1 (T2) infiltrating adenocarcinomas between 1951-93 and of 337 patients treated by preoperative radiotherapy for T2 T3 (T4) rectal cancer, between 1978-92. Endocavitary irradiation was delivered with Papillon's technique using the PHILLIPS RT-50 machine. Preoperative external beam radiotherapy was given to the posterior pelvis only with an accelerated schedule of 39 Gy in 13 fractions over 18 days. Endocavitary irradiation with the use of intra-rectal ultrasound for patient selection resulted in a local control rate of 91% with no complication even in the medically inoperable patients. Preoperative external beam radiotherapy followed by radical resection resulted in a 90% pelvic control rate. Sphincter-sparing surgery was possible in 60% of patients with low or middle rectal lesions.
本研究的目的是分析1951年至1993年间414例接受腔内照射治疗的小T1（T2）浸润性腺癌患者，以及1978年至1992年间337例接受术前放疗的T2、T3（T4）直肠癌患者。腔内照射采用帕皮永技术，使用飞利浦RT - 50机器进行。术前体外照射仅对盆腔后部进行，采用加速方案，在18天内分13次给予39 Gy。使用直肠内超声进行腔内照射以选择患者，即使在医学上无法手术的患者中，局部控制率也达到了91%，且无并发症。术前体外照射后行根治性切除术，盆腔控制率为90%。60%的低位或中位直肠病变患者可行保留括约肌手术。
